CARD15 gene polymorphisms in Serbian patients with Crohn's disease: genotype-phenotype analysis
Marijana B Protic1, Sonja T Pavlovic, Daniela Z Bojic
1Center for Gastroenterology and Hepatology, University Clinical Center, Zvezdara, Belgrade, Serbia. marijanaprotic@beotel.yu
Insights
CARD15 mutations increase Crohn's disease (CD) risk in Serbian populations, particularly the L1007fs variant. These mutations are linked to earlier disease onset, ileal disease, and increased need for surgery.
Area of Science:
- Genetics
- Gastroenterology
- Immunology
Background:
- Crohn's disease (CD) genetic analysis is complicated by heterogeneity and incomplete penetrance.
- CARD15 polymorphisms are associated with CD susceptibility in Western Europe, but population-specific frequencies exist.
Purpose of the Study:
- To determine the prevalence of CARD15 mutations in a Serbian population.
- To investigate the correlation between CARD15 mutations and CD phenotypes in this population.
Main Methods:
- Genotyping of 131 CD patients, 65 ulcerative colitis patients, and 88 healthy controls for three common CARD15 mutations (R702W, G908R, Leu1007insC) using PCR-RFLP.
- Statistical analysis using chi-squared and Student's t-tests.
Main Results:
- CARD15 mutations were found in 35.11% of CD patients, significantly higher than in healthy controls (14.77%) and ulcerative colitis patients (7.69%).
- The L1007fs mutation showed a strong association with CD (P<0.0001).
- CARD15 carriers had increased risk for isolated ileal location (OR 2.30), fibrostenotic behavior (OR 9.86), surgical resection (OR 2.2), and earlier disease onset.
Conclusions:
- CARD15 mutations, particularly L1007fs, are associated with an increased risk of Crohn's disease in central Europeans.
- These mutations correlate with earlier onset, ileal and fibrostenotic disease, and a higher likelihood of requiring surgery.
- No east-west divide in genotype frequency or CD phenotype within Europe was observed, suggesting latitude may not be a primary factor.
Objective:
Genetic heterogeneity and incomplete phenotype penetrance complicate genetic analysis of Crohn's disease (CD). Studies in western Europe have shown that CARD15 polymorphisms increase susceptibility to CD, but frequencies vary within different European populations. The aim here was to evaluate the prevalence of CARD15 mutations and their phenotypic correlation in a Serbian population.
Materials And Methods:
131 patients with CD, 65 patients with ulcerative colitis, and 88 healthy controls were genotyped for three common mutations (R702W, G908R, Leu1007insC) by PCR-restriction fragment length polymorphism. chi and Student's t-test were used for statistical assessment.
Results:
At least one CARD15 disease-associated allele was found in 35.11% patients with CD, 14.77% of healthy controls (P=0.001), and 7.69% patients with ulcerative colitis (P=0.0001). The L1007fs mutation showed a significant association with CD (P<0.0001). The frequency of R702W mutant allele was almost equal in the control group and CD patients Univariate analyses established that CARD15 carriers had a significantly higher risk of isolated ileal location [P=0.042; odds ratio (OR) 2.30; 95% confidence interval (CI): 1.02-5.19], fibrostenotic behavior (P<0.0001; OR 9.86; 95% CI: 4.29-22.62), surgical resection (P=0.036; OR 2.2; CI, 1.046-4.626), and earlier onset of disease (P=0.026).
Conclusion:
This study confirms that CARD15 carriers, especially L1007fs mutants, in central Europeans have an increased risk of CD and it is associated with earlier onset, ileal, fibrostenotic disease and a higher risk of surgery. Any influence of latitude is not matched by an east-west divide on the genotype frequency and phenotype of CD within Europe.
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